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Crystal Eddy

Psychologist β€’ Port Huron, MI

Active NPI 1558785568 Individual Practitioner Female Practitioner
Practice location in NPPES

2186 Water St
Port Huron, MI 480602543

Call 9897236791 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

2186 Water St

Port Huron, MI 480602543

Telephone 9897236791
Organization at the Same NPPES Address or Phone
Shiawassee County Community Mental Health Authority Facility NPI 1174701536

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2014

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Port Huron and Michigan

7 active clinicians are listed under Psychologist with a practice address in Port Huron, MI (2,549 in Michigan).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2024-06-20
Psychologist Primary Specialty

NUCC Taxonomy Code: 103T00000X

License # reported to NPPES MI 6301013666

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Michigan Department of Licensing and Regulatory Affairs.
Look Up on State Board Site

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

2 listed
Bradley Ayers , LMSW

Social Worker - Clinical

NPI 1023430758

Licensed Master Social Worker

Diane Vack , LMSW

Social Worker - Clinical

NPI 1073806733

Licensed Master Social Worker

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

7 Historical Events
πŸ“
Updated Practice Location June 20, 2024

Registered at 2186 WATER ST, PORT HURON, MI 480602543 (Tel: 9897236791)

βœ…
NPI Profile Active February 11, 2014

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) February 11, 2014

Registered at 1555 INDUSTRIAL DR, OWOSSO, MI 488679775 (Tel: 9897236791)

πŸ“
Business Mailing Address (Initial Record) February 11, 2014

Registered at PO BOX 428, OWOSSO, MI 488670428

πŸ‘€
Provider Name / Credentials (Initial Record) February 11, 2014

Recorded as CRYSTAL EDDY

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) February 11, 2014

Psychologist (license number reported to NPPES: MI 6301013666)

🟒
Initial NPI Registration & Enumeration February 11, 2014

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1558785568
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 11, 2014
Last Update: June 20, 2024
Sole Proprietor: No

Mailing Address

Po Box 428

Owosso, MI 488670428

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.